Organization Name: | RIVERVIEW FAMILY MEDICINE LLC |
NPI Number: | 1093902942 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEXTER M GENSOLIN (PRESIDENT) |
Mailing Address: | 1600 E Riverview Ave Ste 107 Napoleon |
State: | OH US |
Postal Code: | 435459806 |
Phone Number: | 4195920800 |
Fax Number: | 4195920815 |
NPI Enumeration Date: | 09/25/2007 |
NPI Last Update Date: | 01/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 35079093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |